40岁以下冠心病冠状动脉病变特点及危险因素的对照研究

A Case Control Study of the Features and Its Risk Factors of Coronary Lesions in Patients under Age 40 with Coronary Heart Disease

目的探讨国人40岁以下冠心病患者的冠状动脉（冠脉）病变特点及其危险因素。方法根据冠脉造影结果将40岁以下行冠脉造影的68例分为冠心病组（46例）和非冠心病组（22例），分析其冠脉病变特点并将危险因素加以对照。结果前降支受累率最高，为76％；男性患者中，多支病变者多于女性（P〈0.05），冠脉病变积分高于女性（11182±5144和7110±3115，P〈0.05）。冠心病家族史和血胆固醇水平为冠心病的主要危险因素，比值比分别为3198（95％可信区间1138～11151），2109（95％可信区1间1126～3146）。冠脉病变积分与男性、胆固醇水平呈正相关，相关系数分别为0.1366和0.1354，P均〈0.05。结论冠脉病变男性重于女性，青年冠心病患者的冠心病家族史是不可忽视的重要危险因素。

Objective To investigate the features and its risk factors of coronary artery lesions in patients with coronary artery disease （CAD） under age 40. Methods Sixty eight adults under 40 years old who had un-dergone coronary angiography （CAG） were divided into 2 groups ： Group I （n=46） with evidence of angio-graphic CAD and group Ⅱ （n=22） with non-CAD as control. The CAD risk factors were also studied. Fie-suits In group I , left anterior descending artery was common （35/46, 76% ） , and male patients had a high incidence of multi-vessel disease （57% vs 30% , P〈0.05）. Family history of CAD and total blood cholester-ol level were the main risk factors, and the odd ratios （OR） were 3.98 [95%, confidence interval （CI） 1.38～11.51] and 2.09 （95%, CI 1.26～3.46）, respectively. A positive correlation was present in angiographic score with males and total cholesterol level. Conclusions Lesions of coronary artery are more severe in males than in females. Family history of CAD is a very important risk fact in young patients.